Payer Compliance Specialist

Job Summary

Seeking a full-time Payer Compliance Specialist to manage payer setup and policy updates, support internal training and clean claims, and engage in cross-functional compliance projects in a fully remote environment.

Key responsibilities

• Maintain payer setup, including fee schedules and portal access, while ensuring readiness for clean claims submission
• Interpret payer contracts and monitor updates to assess impacts and assist with compliance tracking
• Support audit efforts and internal reviews, ensuring training is completed and reference materials are up-to-date

Required qualifications

• Associate's or Bachelor's degree in healthcare administration, business, or a related field, or equivalent work experience
• 3+ years of experience in medical billing, revenue cycle operations, payer compliance, or healthcare auditing
• Experience in a healthcare setting and familiarity with payer contracts and reimbursement policies
• Proficiency with practice management systems and claims processing tools
• Strong spreadsheet and document management skills, preferably in Google Workspace or Microsoft Office